What I wish I’d known I could say no to before birth

By Bettina Rae

When you’re pregnant for the first time, birth is often the last thing you want to think about. Instead, it’s all about the excitement of having a baby, decorating the nursery and purchasing all the teeny tiny baby clothes that you’ll later discover are highly impractical and too much effort to actually use.

You might even pretend that birth isn’t inevitable for most of the 40 weeks, like I did. I even remember naively laughing at the concept of a birth plan and telling others that mine was simply to ‘have a healthy baby’.

I got my healthy baby.

I also came out of my first birth feeling slightly traumatised and with no confidence in my ability as a mother. I felt like I’d failed that first rite of passage.

It wasn’t until I fell pregnant again and decided that I needed it to be different this time that I realised how much of my own power I had actually handed over by not educating myself about my choices.

I trusted wholeheartedly that the hospital would be doing everything in my best interest to help me have the natural uncomplicated birth I’d imagined.

What I hadn’t realised was that hospital staff also have to work under a number of certain guidelines that dictate the length of time a birth ‘should’ take and how it ‘should’ unfold. Because of these timelines, certain practices and interventions are offered to ‘speed things up’ and ‘keep things moving’, even though many of these things can actually stall birth and then further intervention is needed to make sure baby is out ‘on time’.

If I had my first time again, I would definitely be taking more time to learn about how my body worked, how interventions affected the natural process and what I was allowed to say no to.

Vaginal examinations

For many of us, the desire to know how close we are to meeting this darn baby is reason enough to have an vaginal examination. No one ever explains that while you might be 5cm dilated, the next 5cm might take half an hour, or 10 hours. Knowing doesn’t actually speed anything up, and in some cases can slow or halt labour, especially if you feel fear around the examination itself.

While there are some emergency reasons for it, when it’s just to check progress it’s unnecessary. A good midwife can tell from other external signs of a labouring woman how far along she is.

Induction and other medical interventions

At 39 weeks my private obstetrician announced that he would be away on my due date, and that if I was wanting him to be at the birth he could ‘get things moving’ for me. I declined, but that night I had some contractions and in typical first-time-mum fashion freaked out and went into hospital super early. Labour stalled and I was told to stay the night, and that my doctor would kick labour off again in the morning. The next morning my waters were broken and labour was a hard and (overly) intense four hours.

At no point did I question why exactly I was being induced. But my baby wasn’t in distress. I wasn’t overdue – in fact, I was still a day short of 40 weeks. There was no medical reason to induce and yet it wasn’t really offered to me with pros and cons, but rather ‘this is happening’. Not knowing any better, I went along with whatever was offered.

The second time around, I knew better. Our bodies are designed for birth, and just like every other natural process in our body it’s designed to happen in its own time. Trying to take a short cut by inducing labour often leads to needed further interventions later.

If your waters are broken before your body is ready to labour you’ll be required to birth your baby within 24 hours. If your body isn’t ready to contract on its own you’ll be offered synthetic oxytocin to help you contract. These contractions are often felt more intensely than regular contractions because you don’t have your body’s natural feel good hormones to help quell the pain. You might then struggle to cope with the pain and ask for an epidural, which may then lead to needing assistance via the vacuum and an episiotomy to deliver.

Will it always work out this way? Absolutely not. But research does support the fact that accepting interventions and inducement does more often than not lead to a cascade of other interventions later in labour.

Now don’t get me wrong – I’m in no way saying I’m ready to go free birth in the woods. I’m incredibly grateful for our access to medical assistance in an emergency. The majority of births, though, are not emergencies.

Believe me, doing your research beforehand so that you know exactly what you can say no to during labour will be a way better use of your time than buying yet another pair of newborn shoes.